Academic Unit of Gastroenterology, Royal Hallamshire Hospital, Sheffield Teaching Hospital NHS Foundation Trust, Sheffield, United Kingdom.
Academic Unit of Gastroenterology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom.
Clin Transl Gastroenterol. 2020 Jan;11(1):e00121. doi: 10.14309/ctg.0000000000000121.
Celiac disease (CD) is common, affecting approximately 1% of the population. The cornerstone of management is a gluten-free diet, with dietetic advice being the key to aiding implementation. The aim of the study was to assess group clinics in comparison with traditional individual appointments.
Patients with a new diagnosis of CD, confirmed histologically, were prospectively recruited over 18 months in Sheffield, United Kingdom. Patients received either a group clinic or traditional one-to-one appointment, led by a dietitian. Quality-of-life questionnaires were completed at baseline, as well as biochemical parameters being recorded. Patients were followed up at 3 months, where adherence scores were assessed as well as biochemical parameters and quality of life questionnaires being completed.
Sixty patients with CD were prospectively recruited and received either an individual (n = 30) or group clinic (n = 30). A statistically significant reduction in tissue transglutaminase was noted following group clinics (mean 58.5, SD 43.4 U/mL vs mean 13.2, SD 5.7 U/mL, P < 0.01). No significant differences in baseline and follow-up biochemical parameters between one-to-one and group clinics were noted. At follow-up, there was no statistically significant difference between mean gluten-free diet adherence scores (mean 3.1, SD 0.4 vs mean 3.1, SD 0.7, P = 0.66) between one-to-one and group clinics.
This first study assessing group clinics in CD demonstrates they are as effective as traditional one-to-one clinics, with the added benefits of peer support and greater efficiency, with an estimated 54% reduction of dietetic resources.
乳糜泻（CD）较为常见，影响大约 1%的人口。其治疗的基础是无麸质饮食，而饮食建议是帮助实施的关键。本研究旨在评估小组诊所与传统的一对一预约相比的效果。
在英国谢菲尔德，前瞻性地招募了 18 个月内新确诊的、组织学证实的 CD 患者。患者接受小组诊所或传统的一对一预约，由营养师负责。在基线时完成生活质量问卷，记录生化参数。在 3 个月时进行随访，评估依从性评分以及生化参数和生活质量问卷。
前瞻性地招募了 60 名 CD 患者，分别接受一对一（n = 30）或小组诊所（n = 30）治疗。小组诊所后组织转谷氨酰胺酶显著降低（平均 58.5，SD 43.4 U/mL 比平均 13.2，SD 5.7 U/mL，P < 0.01）。一对一和小组诊所之间的生化参数在基线和随访时均无显著差异。随访时，一对一和小组诊所的无麸质饮食依从性评分平均值（平均 3.1，SD 0.4 比平均 3.1，SD 0.7，P = 0.66）无统计学差异。
这是第一项评估 CD 小组诊所的研究，表明它们与传统的一对一诊所一样有效，具有同伴支持和更高效率的额外益处，估计减少了 54%的饮食资源。
